Several months ago, I received a thoughtful email from a reader of this blog who asked me to write a blog post that helped people like her-- people who have chronic pain or illness-- to figure out how to make and keep friends when their energy and health often feels limited, challenged, or uncertain. Not entirely sure I felt qualified to give tips to this heroic population, I asked her if first she'd be willing to share, from her perspective, what she wishes the rest of us understood about our friends (or potential friends) whose health issues might impact how we befriend each other. With nearly 1 in 2 of us suffering from some form of chronic (often invisible) illness, we all want to become far more sensitive and thoughtful in how we interact with one another.

Thank you Lucy Smith (pseudonym) for taking the time and energy to share with us what you've learned since being diagnosed a couple of years ago with a debilitating neurological condition. Her ability to participate in the activities she used to do with friends became very limited and the challenge of maintaining and making friends while also dealing with major illness has been difficult. She knows she's not alone as she's found some connection with others in similar situations and I'm so grateful she's excited to get a conversation started with this blog post.

We welcome the stories, tips, and encouragement from others who have found their health or pain impact their friendships-- we all have much to learn from each other. -- Shasta

In Sickness and in Health: 5 Things I Wish My Friends Knew About Friendship and Illness

When serious illness or disability strikes, especially at a relatively young age, your whole world gets turned upside down. Unfortunately, at a time when you need the most support, many people--both family and friends-- don't know what to say or do and, in the wake of uncertainty, err on the side of not reaching out.

After several years of dealing with debilitating illness that completely changed how I was able to interact with friends, here's what I wish they knew:

Let's Talk About It! It is ok to not know what to say, how to act, or what would be helpful. But I'd wish we could have a conversation about it instead of wondering how my social circle could evaporate almost instantaneously.

Please Keep Reaching Out: I still need friends, actually more than ever. However, I may not be able to do what we used to do together at all or I may not be able to do it if I am unwell that day. It is tough enough to lose the activities that I once enjoyed. I hope that doesn't mean that I lose you too because I can't do them with you. Additionally, I need friends who understand that I may not be able to initiate as much (or at all). Friends struggling with illness may not have any energy or brain power left to initiate and organize but often are feeling lonely and isolated, so initiate more than you might otherwise, even if you've gotten turned down several times. It is really nice to be thought of and included, even if I don't feel well enough to attend a particular get-together. If we do plan something ahead of time, I may not be feeling well when the time comes to get together, so I need understanding about adapting plans or canceling.

Practice Empathy, Instead of Sympathy or Encouragement. Empathy is really helpful for maintaining connection. Brene Brown has some great work on how empathy is different from sympathy. Empathy fuels connection, while sympathy drives disconnection. It is a "me, too", rather than "that's too bad". This 3 minute video gives a great overview:
As she mentioned in the video, rarely does empathy begin with "At least...". Well-meaning friends often want to cheer you up by essentially saying "it could be worse", but sometimes that just makes you feel like you haven't been heard or understood.

Small gestures mean a lot. A. Lot. This can be as simple as offering to help with some chores as part of hanging out - for example, maybe cooking some good food together so I have healthy meals that are easy to reheat when I'm exhausted and in pain. Or it might be a call to ask when you could drop by for a quick visit. Or it might be noticing that a friend couldn't participate in something and asking if any modifications could be made so she could join you next time.

Keep on Sharing Your Life! I really want to hear what is going on in your life - both the difficult parts (even if they seem not to be as difficult as mine) and the successes. I still care about you and want to celebrate your trials and successes.